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  1. #1
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    Brief Medical History Overview

    Fracture of the humerus

    Physical Agents In Rehabilitation
    I have a mid shaft humerus fracture (fully displaced) - left arm, it was caused by a fall from my horse onto frozen ground which happened on the 24th Jan. Went straight to the ER and the bones were realigned and set in a slab plaster cast which went from the top of the shoulder to mid way across the forearm in an L shape. I spent 2 nights in hospital to ensure bones didn't move out of place and to check nerves were OK.
    Before the bone was aligned I had pins and needles in my thumb and index finger but once they were reset this feeling dissipated. However, I did have a 'strange' feeling in these areas for a few weeks which I was told was due to bruising of the radial nerve. I was told to wiggle my fingers, make a fist and move wrist over and back - strength in my hand is improving all the time.

    I had to go back to ER after 1 week as forearm and hand were badly swollen and they were afraid the bone had moved - ended up I was doing too much and was told to rest i.e. do absolutely nothing for 2 weeks...

    After 2.5 weeks I went back to hospital for a checkup as it hadn't been decided whether or not an operation was needed. They managed to loose my original x-rays and the surgeon did not instil much confidence in his answers so wanted to leave me for another 4 weeks to see how things were progressing. At this stage I was going crazy as I did not want to have sit around doing nothing for 6 weeks before they decided I needed an op or not and then have to start recovery from scratch!

    3.5 weeks from break - I went to an upper arm ortho specialist for a 2nd opinion, he was great and elevated all my worries. He examined my arm and wanted to leave it in the slab plaster for another week or so to give it plenty of time to heal - he was able to tell me straight away no op needed!

    He gave me good advice re slab plaster which at this stage had loosened at the shoulder, I found my arm swelled while I was sleeping due to the pressure of this pulling at my inside arm. He said to wrap an 4inch elastic bandage around the plaster and tighten it in so it was more comfortable - it worked.

    Week 5 - after being re x-rayed he removed the slab plaster and grabbed the fracture area moving it over and back (thankfully he didn't tell me he was going to do this in advance!). He announced the bone was 'solid as a rock' although from the x-ray you wouldn't think so. A plastic clam shell brace has been fitted which I can remove when having a bath/shower - must support arm in L shape when doing this. I have to leave this on for another 4 weeks and then back for another check-up.
    He said to move the forearm up an down from the elbow, I've had to do this with my other hand as I don't have the strength to lift it at all - I'm doing reps of 10 numerous times during the day when sitting down. My bi/tri-ceps must not be strong enough yet - muscles her are sore but I expected this.
    Does anyone know how long it takes to start getting strength back here?? Its now a week on and I still can't lift my forearm a mm without pushing it up/down with other hand - is this normal?

    My shoulder muscles are very tight/sore but I've a friend that has being doing acupuncture on it and it has helped relax muscles, the left shoulder seems lower than right at the moment.

    Would appreciate and advice on PT, or how long it takes to get full strenght back?

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  2. #2
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    Re: Fracture of the humerus

    One can't really say how long it will take as everyone is different. Would be great if you could attach an image from your latest x-rays though.

    You will have disuse atrophy from the cast however it is more likely that the brain is inhibiting the muscles from working. This is because some of you biceps group attach across the fracture and as they have been immobile since the fracture they are not sure what damage (or not) they might cause if they were to contract. The fact you can move with assistance is great. Perhaps try the same movement lying on your side and or in the pool.

    You are months away from being anywhere near normal and right now your bones are only just healed. They will take 12 months to fully ossify. You might get your friend and or PT to gentle loosen off your neck muscles as you would have sustained a neck injury at the same time during the fall. Of course pain and focus went to the obvious fracture so you wouldn't have considered the next at the time.

    For future ref, if a plaster slab or full cast is really loose, have them cut it off and re-do it. This is common place in Australia and should be elsewhere. Some people are just plain lazy

    Aussie trained Physiotherapist living and working in London, UK.
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